If you are looking to go south for a month or two in the winter?

@pjas972j Well, as a confirmed Winter Texan and summer Minnesotan, a person with asthma and bronchiectasis, who has had both MAC and pseudomonas, I have NOT let NTM scare me away from my beloved southern home. Any more than I have let it keep me indoors in Minnesota in Spring, Summer and Fall. (Remember NTM is in the air, soil and water near Chicago too.)

When we say "NTM levels are highest" in some places, it is not at all clear to me whether these numbers take into consideration the population demographics. I would expect to see higher numbers in Florida where many retired people relocate or winter. Age is a great factor in NTM infection, since lung damage is more prevalent and immune systems weaken.

Here is what I can tell you - NTM is everywhere, you cannot escape it, but you can live side by side safely with it. In Texas, I live an hour from the coast and travel there often, but I also enjoy swimming in our community's outdoor salt-water pool (I do stay out of the hot tub 😢) I did this while I was being treated for MAC, and for 4 winters since I stopped the medications, with only 3 minor exacerbations in all that time. When it is windy and dusty, or I am doing yard work, I wear a mask (same in MN.) I take my prescribed meds, use my Aerobika and airway clearance daily, neb 7% saline a few times a week. If I have an exacerbation, we add levalbuterol, budosenide and more frequency. I am able to safely socialize - often outdoors - almost every day of the winter, can walk daily without fear of frostbite or slipping on ice, and am around other seniors who understand about protecting our health. (In our small community, sick people are expected to stay home - and may be asked to do so by staff.)

Also, if you are like many of us, NTM isn't your only concern - cold weather makes us ache. I hurt less, I breathe better than in the cold, I am more active.

So the question becomes, would your quality of life be better if you were in a warm place, doing interesting things, and being able to walk (or golf, bird watch, whatever your passion) in comfort?

Does this help in your decision-making?
Sue

When i was njh in march of this year i asked my doctor there if the ocean was bad for mac. She said mac is everywhere and no one place is worst than others. We should be able to enjoy our lives. We just need to be careful. We go to florida in the winter and i don’t feel any different than i do here in asheville. I live surrounded by forest. I feel that is worst than the ocean. I love walking on the beach and breathing the air. The ocean calms me and its so peaceful. Go and enjoy it!😎

Sue, I value your outlook, experience and wisdom regarding living with our condition. I have seen references to avoiding traveling to Hawaii in other threads on this site. What is your feeling about that particular destination?

I live in Florida and for the past 25 years, lived a 10 minute walk from the Gulf of Mexico where I took daily walks on the beach. (recently moved further inland for non-health reasons). I have Bronchiectasis but no NTM’s at this point. I would encourage you to come to FL ( or some other pleasant climate location) for all the reasons Sue stated. Quality of life is so important. I will caution you to keep in mind that FL is full of visitors in the winter so restaurants, parks and beaches are fuller than the rest of the year. But nearly all our restaurants have outside seating and the weather is pleasant so it’s never been a problem for us to go to our favorite spots. Our sun and beaches won’t improve your MAC, but they will be good for your soul!! Good luck!

Quoting @msk "When i was njh in march of this year i asked my doctor there if the ocean was bad for mac. She said mac is everywhere and no one place is worst than others. We should be able to enjoy our lives. We just need to be careful. " This is exactly what I have been told by my primary, my pulmonologist, my infectious disease doc and my counselor.
As to your other question, if I had the opportunity, I would go to Hawaii.

We are going to fly next week to visit some family members - masked, both for our protection and the people we will visit. The only two things we are reluctant to do are a cruise and a days-long group bus tour. Both have resulted in multiple friends and relatives on those trips ending up with Covid or another lung infection.

This is how we, with lung conditions and other ailments, live our life carefully. But we are belt-or-suspenders people, and unlikely to change at this stage of life. If you are a belt-and-suspenders person, tend to be very anxious, or have a very fragile immune system, your decision may be different.was told on the very first day of my Bronchiectasis diagnosis, even before MAC and Pseudomonas were confirmed, by an old time pulmo "Bronchiectasis is a disease you live with, not die from. You will have to make some changes in what you do, but just keep on going." Even so, when I read on Connect and elsewhere, I was originally scared, really scared. Then my sister reminded me that our Mom lived with bronchiectasis, and possibly MAC, for 20 years, and died at 84 of unrelated, inherited heart issues.

This is how my partner and I, with lung conditions and other ailments, live our life carefully. But we are belt-or-suspenders people, and unlikely to change at this stage of life. If you are a belt-and-suspenders person, tend to be very anxious, or have a very fragile immune system, your decision may be different.

I hope you can work out what your comfort level is and go forward,

Sue
PS Last year, within a single week, I met 2 other Winter Texans, from Wisconsin and Colorado, who live with MAC & Bronchiectasis. Bothe are in their 80's, and spend every winter near me.

Thanks, Sue. Yes, your perspective makes sense. It's a big decision - financially, physically, emotionally, etc. I'm trying to make the wisest decision based on all of the factors. I appreciate your input!

I would say one thing I had not counted on when I visited the Gulf Coast in February, near Sarasota, was red tide. The amounts were high and it can vary and be fairly unpredictable. Sadly, our whole week there, the levels were dangerously high for those with lung disease and I felt it (asthma and broncheictasis) even inside! So, I didn't get to visit the beach or the pool and stared out at this glorious oceanfront view from the "safety" of our hotel window! Ugh. So, just my two cents that if you are going to an area that often has red tide, perhaps try to avoid "red tide season."

I live in Colorado and am miserable with a 90% spo2. We have been visiting Gulf Shores, AL and I feel great with an spo2 of 98%. If I can find a Dr there, I will move immediately.

@sueinmn
Thank you for your always practical advice!

Btw- I’m heading to back surgery on Thursday, will let you know how it goes with nebulizing! I did have a case of hemoptysis a few weeks ago, took antibiotics, and sputum reduced by a lot! So I’m thanking God!
Praying for a good RT in hospital!

Hi.
You might be interested in the following articles ---
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9328927/
This one has NTM cases by ethnic groups in Hawaii.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5079566/
This one has the data collected from water and soil in Hawaii.
Hope this helps you to make the decision. 
Some thought:
If the bacterium is isolated in the water and soil in Hawaii, would that be enough if we take the same measures as we do in the mainland? I am Asian, this study shows that Asians are at high risk. Lucky me. I have booked 2 trips to Hawaii, one in Nov. for a week, one for 4 weeks next Jan. Last year I was so scared after the diagnosis of bronchiectasis, so I cancelled our Hawaii trips. To me, to live the life we want is more important. 
Best,
Ling